BACKGROUND Small cell lung cancer(SCLC)is the most malignant type of lung cancer.Even in the latent period and early stage of the tumor,SCLC is prone to produce distant metastases with complex and diverse clinical man...BACKGROUND Small cell lung cancer(SCLC)is the most malignant type of lung cancer.Even in the latent period and early stage of the tumor,SCLC is prone to produce distant metastases with complex and diverse clinical manifestations.SCLC is most closely related to paraneoplastic syndrome,and some cases present as paraneoplastic peripheral neuropathy(PPN).PPN in SCLC appears early,lacks specificity,and often occurs before diagnosis of the primary tumor.It is easy to be misdiagnosed as a primary disease of the nervous system,leading to missed diagnosis and delayed diagnosis and treatment.CASE SUMMARY This paper reports two cases of SCLC with limb weakness as the first symptom.The first symptoms of one patient were rash,limb weakness,and abnormal electromyography.The patient was repeatedly referred to the hospital for limb weakness and rash for>1 year,during which time,treatment with hormones and immunosuppressants did not lead to significant improvement,and the condition gradually aggravated.The patient was later diagnosed with SCLC,and the dyskinesia did not worsen as the dermatomyositis improved after antineoplastic and hormone therapy.The second case presented with limb numbness and weakness as the first symptom,but the patient did not pay attention to it.Later,the patient was diagnosed with SCLC after facial edema caused by tumor thrombus invading the vein.However,he was diagnosed with extensive SCLC and died 1 year after diagnosis.CONCLUSION The two cases had PPN and abnormal electromyography,highlighting its correlation with early clinical indicators of SCLC.展开更多
Objective： To discuss the clinical and imaging diagnostic rules of peripheral lung cancer by data mining technique, and to explore new ideas in the diagnosis of peripheral lung cancer, and to obtain early-stage techn...Objective： To discuss the clinical and imaging diagnostic rules of peripheral lung cancer by data mining technique, and to explore new ideas in the diagnosis of peripheral lung cancer, and to obtain early-stage technology and knowledge support of computer-aided detecting （CAD）. Methods： 58 cases of peripheral lung cancer confirmed by clinical pathology were collected. The data were imported into the database after the standardization of the clinical and CT findings attributes were identified. The data was studied comparatively based on Association Rules （AR） of the knowledge discovery process and the Rough Set （RS） reduction algorithm and Genetic Algorithm（GA） of the generic data analysis tool （ROSETTA）, respectively. Results： The genetic classification algorithm of ROSETTA generates 5 000 or so diagnosis rules. The RS reduction algorithm of Johnson＇s Algorithm generates 51 diagnosis rules and the AR algorithm generates 123 diagnosis rules. Three data mining methods basically consider gender, age, cough, location, lobulation sign, shape, ground-glass density attributes as the main basis for the diagnosis of peripheral lung cancer. Conclusion： These diagnosis rules for peripheral lung cancer with three data mining technology is same as clinical diagnostic rules, and these rules also can be used to build the knowledge base of expert system. This study demonstrated the potential values of data mining technology in clinical imaging diagnosis and differential diagnosis.展开更多
BACKGROUND Peripheral lung cancer poses a substantial harm to human health,and it is easy to become exacerbated,potentially threatening the life and safety of patients AIM To assess the value of virtual bronchoscopic ...BACKGROUND Peripheral lung cancer poses a substantial harm to human health,and it is easy to become exacerbated,potentially threatening the life and safety of patients AIM To assess the value of virtual bronchoscopic navigation(VBN)combined with transbronchial ultrasound-guided sheath-guided(EBUS-GS)exploration in the diagnosis of peripheral lung cancer.METHODS A total of 236 patients with peripheral lung cancer(nodule diameter range,8-30 mm;diagnosed using high-resolution computed tomography)were selected from three centers between October 2018 and December 2019.Patients who underwent EBUS-GS exploration alone were included in a control group,and those who received VBN in combination with EBUS-GS exploration were included in an observation group.The diagnostic rate and total operating time of differentsubgroups of the two groups were compared,and the time needed to determine the lesion was recorded.RESULTS There were no significant differences in diagnosis rate or total operation time between the two groups(P>0.05),and the time needed to determine the lesion in the observation group was less than that of the control group(P<0.05).CONCLUSION The combined use of VBN and EBUS-GS exploration technology has little effect on the diagnosis rate and total operation time of peripheral lung cancer,but it significantly shortens the time needed to determine the lesion and is a valuable diagnostic method.展开更多
Objective: The purpose of this study was to evaluate the diagnostic value of transbronchial lung biopsy (TBLB) in peripheral lung cancer. Methods: 78 cases of peripheral lung cancer which could not be observed by bron...Objective: The purpose of this study was to evaluate the diagnostic value of transbronchial lung biopsy (TBLB) in peripheral lung cancer. Methods: 78 cases of peripheral lung cancer which could not be observed by bronchoscope were selected from the Second Affiliated Hospital of Sun Yat-sen University (China), of which 42 cases were diagnosed by TBLB. Among the 36 cases of peripheral lung cancer that could not be able to be diagnosed by TBLB, 22 cases were diagnosed by percutaneous lung biopsy (PNLB) and 14 cases being left were diagnosed by surgical specimens biopsy, lymphadenopathy biopsy, pleural biopsy or pleural effusion cytology. Results: The positive rates produced by TBLB and transbronchial brush biopsy were 53.8% and 8.9%, respectively, and the combined positive rate was 57.7%. The positive rate produced by TBLB was higher than that of transbronchial brush biopsy (P < 0.01). As the tumor’s diameter increased, the positive rate of the biopsy was higher (P < 0.05). The positive rate of biopsy of the right lung was not significantly higher than that of the left lung (P > 0.05). The positive rate of biopsy of the inferior lobes was not significantly higher than that of the upper lobes of the lung (P > 0.05). The lesions of the tumors which were nearer to the infield and hilar of the lung got a higher positive rate (P < 0.01). The incidence of complications in PNLB was much higher than that in TBLB (P < 0.05). Conclusion: TBLB is an important method in the diagnosis of peripheral lung cancer. Combination of TBLB and other methods can increase the positive rate in the diagnosis of peripheral lung cancer.展开更多
Previous study has demonstrated that the peripheral blood CD44 expression level is related with the clinical stage and lymph node metastasis of lung cancer. The present comment was to investigate the relationship betw...Previous study has demonstrated that the peripheral blood CD44 expression level is related with the clinical stage and lymph node metastasis of lung cancer. The present comment was to investigate the relationship between the peripheral blood CD44 expression level and clinic pathological change in 50 patients with non-small cell lung cancer (NSCLC) by flow cytometry method. The results showed that 1) the peripheral blood CD44 expression level in the NSCLC group was higher than that in the benign group (467 ± 15) or the normal group (448 ± 15);2) operation decreased the peripheral blood CD44 expression level in the NSCLC group (533 ± 10 vs. 324 ± 11);3) it also showed same results in NSCLC patients with and without lymph node metastasis (559 ± 12 vs. 477 ± 15) or before and after chemotherapy (550 ± 13 vs. 372 ± 10);4) there were significant differences in the peripheral blood CD44 expression level in non-small cell lung cancer patients of the clinical stage I, II, III and IV (474 ± 14, 526 ± 12, 528 ± 16 and 599 ± 20);And the peripheral blood CD44 expression level was not associated with the clinical pathology parameter including the patient age, gender and tumor size. The data suggested that the peripheral blood CD44 expression level was related with the NSCLC progress, lymphatic metastasis and clinical treatment, and the peripheral blood CD44 expression level as the clinical regular examination should evaluate the progress, lymphatic metastasis and clinical treatment for the patients with NSCLC.展开更多
Objective: To investigate the relationship between the activation markers of platelets and the lung cancer. Meth- ods: Based on international stages of lung cancer in 1997, lung cancer patients of 120 cases diagnosed ...Objective: To investigate the relationship between the activation markers of platelets and the lung cancer. Meth- ods: Based on international stages of lung cancer in 1997, lung cancer patients of 120 cases diagnosed by pathology as well as with operation indication were selected as the experimental group. During the process of experiment, 60 cases concluded as healthy in the physical examination were chosen as control group. The activation markers of platelets were detected by FCM method. The experimental result would be processed by SPSS 11.5. Results: The level of activation markers of platelets in peripheral blood of lung cancer patients was significantly higher than those healthy people (P < 0.01). The level of activation markers of platelets in peripheral blood of lung cancer patients on the seventh postoperative day was significantly lower than that before operation and on the first postoperative day (P < 0.01). The level of activation markers of platelets in peripheral blood of lung cancer patients was closely related to the size of the primary tumor, lymph node status and stages, but not to the grade of cell differentiation, type of tumor, age, sex of the patients (P > 0.05). Conclusion: Elevation of the level of activation markers of platelets in peripheral blood exists in lung cancer patients and the levels of activation marker of platelets plays an important role in tumor growth and lymphatic metastasis. The levels of activation markers of platelets maybe a predictor for prognosis.展开更多
A NF1 (neurofibromatosis 1) patient developed multiple necrotic lung metastases</span><span style="font-family:Verdana;"> from a sciatic malignant peripheral nerve sheath tumor (MPNST) invad...A NF1 (neurofibromatosis 1) patient developed multiple necrotic lung metastases</span><span style="font-family:Verdana;"> from a sciatic malignant peripheral nerve sheath tumor (MPNST) invading the superficial femoral artery. The first diagnosis was metastases of a non-small-cell adenocarcinoma because the right calf MPNST was not clinical</span><span style="font-family:Verdana;">ly noticeable ant that the chest/abdomen PET/CT did not include the region of the legs. When the MPNST was diagnosed, new histological analysis on the </span><span style="font-family:Verdana;">metastases changed the diagnosis to that of epithelioid undifferentiated sarcoma.</span><span style="font-family:Verdana;"> The article deals with the sometimes-delayed diagnosis in those NF1 patients </span><span style="font-family:Verdana;">with large palpable masses and chronic pain pre-existing the malignant transformat</span><span style="font-family:Verdana;">ion, and discusses the difficulty of the biopsy of necrotic metastases.展开更多
Objective:To explore the correlation between peripheral circulating tumor cells and hypercoagulability in patients with lung cancer after surgery.Methods:From January 2017 to December 2021,89 patients with lung cancer...Objective:To explore the correlation between peripheral circulating tumor cells and hypercoagulability in patients with lung cancer after surgery.Methods:From January 2017 to December 2021,89 patients with lung cancer who were treated in the Affiliated Hospital of Hebei University were selected as the research subjects,and a retrospective analysis was conducted to analyze and observe the D-dimer(DD),fibrinogen(FIB),and platelet(PLT)levels in peripheral blood,as well as detect peripheral CTC.Results:There were statistical differences in TMN staging,tumor metastasis,and lymph node metastasis in the clinical data,but there were no statistical differences in gender,smoking history,and pathological classification.After retrospective analysis and comparison of the patients,the DD(mg/ml),FIB(g/L),and PLT(×10^(9)/L)levels of the CTC positive group were 3.41±0.58,3.98±0.87,and 367.26±34.98,respectively;the CTC negative group’s DD(mg/ml),FIB(g/L),and PLT(×10^(9)/L)levels were 0.89±0.49,1.06±0.45,and 234.69±35.69,respectively,and the differences were statistically significant.The factors affecting the prognosis of patients included TMN staging and CTC;the number of CTC positives in the death group was significantly higher than that in the survival group,and there was a statistical difference between the groups.Gender,age,smoking history,pathological type,and surgical resection had no effect on the prognosis of patients.Among the enrolled patients,the survival rate was 71.91%.Conclusion:CTC-positive patients have a higher probability of hypercoagulability after surgery and are prone to tumor metastasis;thus,CTC can be used as a judgment index for the prognosis of patients.展开更多
Objective To study the risk factors of mediastinal lymph node metastasis in patients with ≤3 cm peripheral non small cell lung cancer. Methods From January 2000 to December 2010,a total of 281 patients with NSCLC [15...Objective To study the risk factors of mediastinal lymph node metastasis in patients with ≤3 cm peripheral non small cell lung cancer. Methods From January 2000 to December 2010,a total of 281 patients with NSCLC [152 men and 129 women,aged (60. 31 ± 12. 13) years; ≤ 3 cm in diameter]underwent lobectomy or partial resection with systematic mediastinal lymphadenectomy in hospital. Clinical data included age,gender,展开更多
BACKGROUND The incidence and mortality of lung cancer have increased annually.Accurate diagnosis can help improve therapeutic efficacy of interventions and prognosis.Percutaneous lung biopsy is a reliable method for t...BACKGROUND The incidence and mortality of lung cancer have increased annually.Accurate diagnosis can help improve therapeutic efficacy of interventions and prognosis.Percutaneous lung biopsy is a reliable method for the clinical diagnosis of lung cancer.Ultrasound-guided percutaneous lung biopsy technology has been widely promoted and applied in recent years.AIM To investigate the diagnostic value of contrast-enhanced ultrasound(CEUS)-guided percutaneous biopsy in peripheral pulmonary lesions.METHODS We retrospectively collected data on 237 patients with peripheral thoracic focal lesions who underwent puncture biopsy at Wuxi People’s Hospital.The patients were randomly divided into two groups:The CEUS-guided before lesion puncture group(contrast group)and conventional ultrasound-guided group(control group).Analyze the diagnostic efficacy of the puncture biopsy,impact of tumor size,and number of puncture needles and complications were analyzed and compared between the two groups.RESULTS Accurate pathological results were obtained for 92.83%(220/237)of peripheral lung lesions during the first biopsy,with an accuracy rate of 95.8%(113/118)in the contrast group and 89.9%(107/119)in the control group.The difference in the area under the curve(AUC)between the contrast and the control groups was not statistically significant(0.952 vs 0.902,respectively;P>0.05).However,when the lesion diameter≥5 cm,the diagnostic AUC of the contrast group was higher than that of the control group(0.952 vs 0.902,respectively;P<0.05).In addition,the average number of puncture needles in the contrast group was lower than that in the control group(2.58±0.53 vs 2.90±0.56,respectively;P<0.05).CONCLUSION CEUS guidance can enhance the efficiency of puncture biopsy of peripheral pulmonary lesions,especially for lesions with a diameter≥5 cm.Therefore,CEUS guidance has high clinical diagnostic value in puncture biopsy of peripheral focal lung lesions.展开更多
Objective: To evaluate the safety, efficacy, feasibility of single-direction thoracoscopic lobectomy for peripheral lung cancer. Methods: From December 2009 to March 2011, 20 patients with peripheral lung cancer were ...Objective: To evaluate the safety, efficacy, feasibility of single-direction thoracoscopic lobectomy for peripheral lung cancer. Methods: From December 2009 to March 2011, 20 patients with peripheral lung cancer were treated with single-direction thoracoscopic lobectomy and systemic lymph nodes dissection. Results: Surgeries were successfully performed. No significant complications occurred perioperatively. The average operation time was 193 min, the average blood loss was 234 ml, the average duration of drainage was 6 d, the postoperative hospital stay was 12 d, and the average number of lymph nodes dissected was 16. Conclusion: Single-direction thoracoscopic lobectomy is feasible and safe in the treatment of peripheral lung cancer and can simplify the surgical procedures.展开更多
Objective:Fluoroscopy guidance is generally required for endobronchial ultrasonography with guide sheath(EBUS-GS)in peripheral pulmonary lesions(PPLs).Virtual bronchoscopic navigation(VBN)can guide the bronchoscope by...Objective:Fluoroscopy guidance is generally required for endobronchial ultrasonography with guide sheath(EBUS-GS)in peripheral pulmonary lesions(PPLs).Virtual bronchoscopic navigation(VBN)can guide the bronchoscope by creating virtual images of the bronchial route to the lesion.The diagnostic yield and safety profiles of VBN without fluoroscopy for PPLs have not been evaluated in inexperienced pulmonologist performing EBUS-GS.Methods:Between January 2016 and June 2017,consecutive patients with PPLs referred for EBUS-GS at a single cancer center were enrolled.The diagnostic yield as well as safety profiles was retrospectively analyzed,and our preliminary experience was shared.Results:A total of 109 patients with 109 lesions were included,99(90.8%)lesions were visible on EBUS imaging.According to the procedure time needed to locate the lesion on EBUS,24.8%(27/109)were deemed technically difficult procedures;however,no significant relationships were identified between candidate parameters and technically difficult procedures.The overall diagnosis yield was 74.3%(81/109),and the diagnostic yield of malignancy was 83.7%(77/92).Lesions larger than 20 mm[odds ratio(OR),2.758;95%confidence interval(95%CI),1.077-7.062;P=0.034]and probe of within type(OR,3.174;95%CI,1.151-8.757,P=0.026)were independent factors leading to a better diagnostic yield in multivariate analysis.About 30 practice procedures were needed to achieve a stable diagnostic yield,and the proportion of technically difficult procedures decreased and stabilized after 70 practice procedures.Regarding complications,one patient(0.9%)had intraoperative hemorrhage(100 mL)which was managed under endoscopy.Conclusions:VBN without fluoroscopy guidance is still useful and safe for PPLs diagnosis,especially for malignant diseases when performed by pulmonologist without previous experience of EBUS-GS.VBN may simplify the process of lesion positioning and further multi-center randomized studies are warranted.展开更多
Purpose:To investigate the correlations of pulmonary high-resolution computed tomography(HRCT)findings and their distribution with the peripheral blood immunological parameters of swine-origin influenza A(H1N1)infecti...Purpose:To investigate the correlations of pulmonary high-resolution computed tomography(HRCT)findings and their distribution with the peripheral blood immunological parameters of swine-origin influenza A(H1N1)infection.Materials and methods:173 patients with H1N1 influenza infection underwent HRCT.CD4^(+)and CD8^(+)lymphocyte counts and C-reactive protein(CRP)levels in the peripheral blood were measured on the day of admission.According to the predominant HRCT findings,we created three groups:Group A=normal attenuation,Group B=ground-glass opacity(GGO),Group C=consolidation with or without GGO.We classified the extent of lung lesions into five groups as follows:Group 1=CT score of 0;Group 2=CT score of 0.01-0.25;Group 3=CT score of 0.26-0.50;Group 4=CT score of 0.51-0.75;Group 5=CT score of 0.75-1.00.Results:The CD4^(+)and CD8^(+)lymphocyte counts decreased with the degree of the attenuation and the extent of the lesions on HRCT(P<0.001),whereas the CRP levels increased with the degree of the attenuation and the extent of the lesions(P<0.001).Conclusions:The HRCT findings correlated with the CD4^(+)and CD8^(+)lymphocyte counts and the CRP level in the peripheral blood of patients in the initial stage of influenza infections.展开更多
BACKGROUND Colorectal cancer(CRC)ranks high among the most common types of malignant tumors.The primary cause of cancer-related mortality is metastasis,with lung metastases accounting for 32.9%of all cases of metastat...BACKGROUND Colorectal cancer(CRC)ranks high among the most common types of malignant tumors.The primary cause of cancer-related mortality is metastasis,with lung metastases accounting for 32.9%of all cases of metastatic CRC(MCRC).However,cases of MCRC in the lungs,which present concurrently with primary peripheral lung adenocarcinoma,are exceptionally rare.CASE SUMMARY This report describes the case of a 52-year-old female patient who,following a colonoscopy,was diagnosed with moderately differentiated adenocarcinoma based on rectal mucosal biopsy findings.A preoperative chest computed tomography scan revealed a ground-glass nodule in the right lung and a small nodule(approximately 0.6 cm in diameter)in the extramural basal segment of the left lower lobe,which suggested multiple lung metastases from rectal cancer.Subsequent treatment and follow-up led to a diagnosis of rectal cancer with left lung metastasis and peripheral adenocarcinoma of the lower lobe of the right lung.CONCLUSION This case report describes the therapeutic journey of a patient with lung metastasis from rectal cancer in addition to primary peripheral adenocarcinoma,thus underscoring the critical roles of multidisciplinary collaboration,personalized treatment strategies,and comprehensive patient rehabilitation guidance.展开更多
More peripheral pulmonary lesions(PPLs)are detected by low-dose helical computed tomography(CT)either in-cidentally or via dedicated lung cancer screening programs.Thus,using methods for safe and accurate diagnosis of...More peripheral pulmonary lesions(PPLs)are detected by low-dose helical computed tomography(CT)either in-cidentally or via dedicated lung cancer screening programs.Thus,using methods for safe and accurate diagnosis of these lesions has become increasingly important.Transthoracic needle aspiration(TTNA)and transbronchial lung biopsy(TBLB)are routinely performed during the diagnostic workup for PPLs.However,TTNA often car-ries the risk of pneumothorax,uncontrollable airway hemorrhage,and does not allow mediastinal staging in one procedure.In contrast,traditional TBLB often has a poorer diagnostic yield despite fewer complications.With the ongoing development of technology applied to bronchoscopy,guided bronchoscopy has become widely used and the diagnostic yield of TBLB has improved.Additionally,guided bronchoscopy continues to demonstrate a better safety profile than TTNA.In recent years,robotic-assisted bronchoscopy(RAB)has been introduced and imple-mented in the diagnosis of PPLs.At present,RAB has two platforms that are commercially available:Monarch TM and Ion TM;several other platforms are under development.Both systems differ in characteristics,advantages,and limitations and offer features not seen in previous guided bronchoscopy.Several studies,including cadaveric model studies and clinical trials,have been conducted to examine the feasibility and performance of RAB using these two systems;large multicenter studies are underway.In this review,published experimental results,focus-ing on diagnostic yield and complications of RAB,are analyzed and the potential clinical application of RAB is discussed,which will enable the operators to have a clear overview of RAB.展开更多
基金Supported by Science and Technology Plan Project of Jiaxing,No.2021AD30044Supporting Discipline of Neurology in Jiaxing,No.2023-ZC-006Affiliated Hospital of Jiaxing University,No.2020-QMX-16.
文摘BACKGROUND Small cell lung cancer(SCLC)is the most malignant type of lung cancer.Even in the latent period and early stage of the tumor,SCLC is prone to produce distant metastases with complex and diverse clinical manifestations.SCLC is most closely related to paraneoplastic syndrome,and some cases present as paraneoplastic peripheral neuropathy(PPN).PPN in SCLC appears early,lacks specificity,and often occurs before diagnosis of the primary tumor.It is easy to be misdiagnosed as a primary disease of the nervous system,leading to missed diagnosis and delayed diagnosis and treatment.CASE SUMMARY This paper reports two cases of SCLC with limb weakness as the first symptom.The first symptoms of one patient were rash,limb weakness,and abnormal electromyography.The patient was repeatedly referred to the hospital for limb weakness and rash for>1 year,during which time,treatment with hormones and immunosuppressants did not lead to significant improvement,and the condition gradually aggravated.The patient was later diagnosed with SCLC,and the dyskinesia did not worsen as the dermatomyositis improved after antineoplastic and hormone therapy.The second case presented with limb numbness and weakness as the first symptom,but the patient did not pay attention to it.Later,the patient was diagnosed with SCLC after facial edema caused by tumor thrombus invading the vein.However,he was diagnosed with extensive SCLC and died 1 year after diagnosis.CONCLUSION The two cases had PPN and abnormal electromyography,highlighting its correlation with early clinical indicators of SCLC.
文摘Objective： To discuss the clinical and imaging diagnostic rules of peripheral lung cancer by data mining technique, and to explore new ideas in the diagnosis of peripheral lung cancer, and to obtain early-stage technology and knowledge support of computer-aided detecting （CAD）. Methods： 58 cases of peripheral lung cancer confirmed by clinical pathology were collected. The data were imported into the database after the standardization of the clinical and CT findings attributes were identified. The data was studied comparatively based on Association Rules （AR） of the knowledge discovery process and the Rough Set （RS） reduction algorithm and Genetic Algorithm（GA） of the generic data analysis tool （ROSETTA）, respectively. Results： The genetic classification algorithm of ROSETTA generates 5 000 or so diagnosis rules. The RS reduction algorithm of Johnson＇s Algorithm generates 51 diagnosis rules and the AR algorithm generates 123 diagnosis rules. Three data mining methods basically consider gender, age, cough, location, lobulation sign, shape, ground-glass density attributes as the main basis for the diagnosis of peripheral lung cancer. Conclusion： These diagnosis rules for peripheral lung cancer with three data mining technology is same as clinical diagnostic rules, and these rules also can be used to build the knowledge base of expert system. This study demonstrated the potential values of data mining technology in clinical imaging diagnosis and differential diagnosis.
文摘BACKGROUND Peripheral lung cancer poses a substantial harm to human health,and it is easy to become exacerbated,potentially threatening the life and safety of patients AIM To assess the value of virtual bronchoscopic navigation(VBN)combined with transbronchial ultrasound-guided sheath-guided(EBUS-GS)exploration in the diagnosis of peripheral lung cancer.METHODS A total of 236 patients with peripheral lung cancer(nodule diameter range,8-30 mm;diagnosed using high-resolution computed tomography)were selected from three centers between October 2018 and December 2019.Patients who underwent EBUS-GS exploration alone were included in a control group,and those who received VBN in combination with EBUS-GS exploration were included in an observation group.The diagnostic rate and total operating time of differentsubgroups of the two groups were compared,and the time needed to determine the lesion was recorded.RESULTS There were no significant differences in diagnosis rate or total operation time between the two groups(P>0.05),and the time needed to determine the lesion in the observation group was less than that of the control group(P<0.05).CONCLUSION The combined use of VBN and EBUS-GS exploration technology has little effect on the diagnosis rate and total operation time of peripheral lung cancer,but it significantly shortens the time needed to determine the lesion and is a valuable diagnostic method.
文摘Objective: The purpose of this study was to evaluate the diagnostic value of transbronchial lung biopsy (TBLB) in peripheral lung cancer. Methods: 78 cases of peripheral lung cancer which could not be observed by bronchoscope were selected from the Second Affiliated Hospital of Sun Yat-sen University (China), of which 42 cases were diagnosed by TBLB. Among the 36 cases of peripheral lung cancer that could not be able to be diagnosed by TBLB, 22 cases were diagnosed by percutaneous lung biopsy (PNLB) and 14 cases being left were diagnosed by surgical specimens biopsy, lymphadenopathy biopsy, pleural biopsy or pleural effusion cytology. Results: The positive rates produced by TBLB and transbronchial brush biopsy were 53.8% and 8.9%, respectively, and the combined positive rate was 57.7%. The positive rate produced by TBLB was higher than that of transbronchial brush biopsy (P < 0.01). As the tumor’s diameter increased, the positive rate of the biopsy was higher (P < 0.05). The positive rate of biopsy of the right lung was not significantly higher than that of the left lung (P > 0.05). The positive rate of biopsy of the inferior lobes was not significantly higher than that of the upper lobes of the lung (P > 0.05). The lesions of the tumors which were nearer to the infield and hilar of the lung got a higher positive rate (P < 0.01). The incidence of complications in PNLB was much higher than that in TBLB (P < 0.05). Conclusion: TBLB is an important method in the diagnosis of peripheral lung cancer. Combination of TBLB and other methods can increase the positive rate in the diagnosis of peripheral lung cancer.
文摘Previous study has demonstrated that the peripheral blood CD44 expression level is related with the clinical stage and lymph node metastasis of lung cancer. The present comment was to investigate the relationship between the peripheral blood CD44 expression level and clinic pathological change in 50 patients with non-small cell lung cancer (NSCLC) by flow cytometry method. The results showed that 1) the peripheral blood CD44 expression level in the NSCLC group was higher than that in the benign group (467 ± 15) or the normal group (448 ± 15);2) operation decreased the peripheral blood CD44 expression level in the NSCLC group (533 ± 10 vs. 324 ± 11);3) it also showed same results in NSCLC patients with and without lymph node metastasis (559 ± 12 vs. 477 ± 15) or before and after chemotherapy (550 ± 13 vs. 372 ± 10);4) there were significant differences in the peripheral blood CD44 expression level in non-small cell lung cancer patients of the clinical stage I, II, III and IV (474 ± 14, 526 ± 12, 528 ± 16 and 599 ± 20);And the peripheral blood CD44 expression level was not associated with the clinical pathology parameter including the patient age, gender and tumor size. The data suggested that the peripheral blood CD44 expression level was related with the NSCLC progress, lymphatic metastasis and clinical treatment, and the peripheral blood CD44 expression level as the clinical regular examination should evaluate the progress, lymphatic metastasis and clinical treatment for the patients with NSCLC.
基金Supported by a grant from the State Education Commission Founda-tion of Yunnan province of China (No. 04Y036C)
文摘Objective: To investigate the relationship between the activation markers of platelets and the lung cancer. Meth- ods: Based on international stages of lung cancer in 1997, lung cancer patients of 120 cases diagnosed by pathology as well as with operation indication were selected as the experimental group. During the process of experiment, 60 cases concluded as healthy in the physical examination were chosen as control group. The activation markers of platelets were detected by FCM method. The experimental result would be processed by SPSS 11.5. Results: The level of activation markers of platelets in peripheral blood of lung cancer patients was significantly higher than those healthy people (P < 0.01). The level of activation markers of platelets in peripheral blood of lung cancer patients on the seventh postoperative day was significantly lower than that before operation and on the first postoperative day (P < 0.01). The level of activation markers of platelets in peripheral blood of lung cancer patients was closely related to the size of the primary tumor, lymph node status and stages, but not to the grade of cell differentiation, type of tumor, age, sex of the patients (P > 0.05). Conclusion: Elevation of the level of activation markers of platelets in peripheral blood exists in lung cancer patients and the levels of activation marker of platelets plays an important role in tumor growth and lymphatic metastasis. The levels of activation markers of platelets maybe a predictor for prognosis.
文摘A NF1 (neurofibromatosis 1) patient developed multiple necrotic lung metastases</span><span style="font-family:Verdana;"> from a sciatic malignant peripheral nerve sheath tumor (MPNST) invading the superficial femoral artery. The first diagnosis was metastases of a non-small-cell adenocarcinoma because the right calf MPNST was not clinical</span><span style="font-family:Verdana;">ly noticeable ant that the chest/abdomen PET/CT did not include the region of the legs. When the MPNST was diagnosed, new histological analysis on the </span><span style="font-family:Verdana;">metastases changed the diagnosis to that of epithelioid undifferentiated sarcoma.</span><span style="font-family:Verdana;"> The article deals with the sometimes-delayed diagnosis in those NF1 patients </span><span style="font-family:Verdana;">with large palpable masses and chronic pain pre-existing the malignant transformat</span><span style="font-family:Verdana;">ion, and discusses the difficulty of the biopsy of necrotic metastases.
基金Baoding Science and Technology Project(Project Number:18ZF134)Youth Fund of Affiliated Hospital of Hebei University(Project Number:2017Q018)。
文摘Objective:To explore the correlation between peripheral circulating tumor cells and hypercoagulability in patients with lung cancer after surgery.Methods:From January 2017 to December 2021,89 patients with lung cancer who were treated in the Affiliated Hospital of Hebei University were selected as the research subjects,and a retrospective analysis was conducted to analyze and observe the D-dimer(DD),fibrinogen(FIB),and platelet(PLT)levels in peripheral blood,as well as detect peripheral CTC.Results:There were statistical differences in TMN staging,tumor metastasis,and lymph node metastasis in the clinical data,but there were no statistical differences in gender,smoking history,and pathological classification.After retrospective analysis and comparison of the patients,the DD(mg/ml),FIB(g/L),and PLT(×10^(9)/L)levels of the CTC positive group were 3.41±0.58,3.98±0.87,and 367.26±34.98,respectively;the CTC negative group’s DD(mg/ml),FIB(g/L),and PLT(×10^(9)/L)levels were 0.89±0.49,1.06±0.45,and 234.69±35.69,respectively,and the differences were statistically significant.The factors affecting the prognosis of patients included TMN staging and CTC;the number of CTC positives in the death group was significantly higher than that in the survival group,and there was a statistical difference between the groups.Gender,age,smoking history,pathological type,and surgical resection had no effect on the prognosis of patients.Among the enrolled patients,the survival rate was 71.91%.Conclusion:CTC-positive patients have a higher probability of hypercoagulability after surgery and are prone to tumor metastasis;thus,CTC can be used as a judgment index for the prognosis of patients.
文摘Objective To study the risk factors of mediastinal lymph node metastasis in patients with ≤3 cm peripheral non small cell lung cancer. Methods From January 2000 to December 2010,a total of 281 patients with NSCLC [152 men and 129 women,aged (60. 31 ± 12. 13) years; ≤ 3 cm in diameter]underwent lobectomy or partial resection with systematic mediastinal lymphadenectomy in hospital. Clinical data included age,gender,
基金the Ethic Committee of Wuxi People's Hospital(No.KY17071).
文摘BACKGROUND The incidence and mortality of lung cancer have increased annually.Accurate diagnosis can help improve therapeutic efficacy of interventions and prognosis.Percutaneous lung biopsy is a reliable method for the clinical diagnosis of lung cancer.Ultrasound-guided percutaneous lung biopsy technology has been widely promoted and applied in recent years.AIM To investigate the diagnostic value of contrast-enhanced ultrasound(CEUS)-guided percutaneous biopsy in peripheral pulmonary lesions.METHODS We retrospectively collected data on 237 patients with peripheral thoracic focal lesions who underwent puncture biopsy at Wuxi People’s Hospital.The patients were randomly divided into two groups:The CEUS-guided before lesion puncture group(contrast group)and conventional ultrasound-guided group(control group).Analyze the diagnostic efficacy of the puncture biopsy,impact of tumor size,and number of puncture needles and complications were analyzed and compared between the two groups.RESULTS Accurate pathological results were obtained for 92.83%(220/237)of peripheral lung lesions during the first biopsy,with an accuracy rate of 95.8%(113/118)in the contrast group and 89.9%(107/119)in the control group.The difference in the area under the curve(AUC)between the contrast and the control groups was not statistically significant(0.952 vs 0.902,respectively;P>0.05).However,when the lesion diameter≥5 cm,the diagnostic AUC of the contrast group was higher than that of the control group(0.952 vs 0.902,respectively;P<0.05).In addition,the average number of puncture needles in the contrast group was lower than that in the control group(2.58±0.53 vs 2.90±0.56,respectively;P<0.05).CONCLUSION CEUS guidance can enhance the efficiency of puncture biopsy of peripheral pulmonary lesions,especially for lesions with a diameter≥5 cm.Therefore,CEUS guidance has high clinical diagnostic value in puncture biopsy of peripheral focal lung lesions.
文摘Objective: To evaluate the safety, efficacy, feasibility of single-direction thoracoscopic lobectomy for peripheral lung cancer. Methods: From December 2009 to March 2011, 20 patients with peripheral lung cancer were treated with single-direction thoracoscopic lobectomy and systemic lymph nodes dissection. Results: Surgeries were successfully performed. No significant complications occurred perioperatively. The average operation time was 193 min, the average blood loss was 234 ml, the average duration of drainage was 6 d, the postoperative hospital stay was 12 d, and the average number of lymph nodes dissected was 16. Conclusion: Single-direction thoracoscopic lobectomy is feasible and safe in the treatment of peripheral lung cancer and can simplify the surgical procedures.
基金This study was supported by Beijing Municipal Hospital Scientific Research Cultivation Program(No.PX2016057).We thank Xiaoping Kang for her help in data analysis.
文摘Objective:Fluoroscopy guidance is generally required for endobronchial ultrasonography with guide sheath(EBUS-GS)in peripheral pulmonary lesions(PPLs).Virtual bronchoscopic navigation(VBN)can guide the bronchoscope by creating virtual images of the bronchial route to the lesion.The diagnostic yield and safety profiles of VBN without fluoroscopy for PPLs have not been evaluated in inexperienced pulmonologist performing EBUS-GS.Methods:Between January 2016 and June 2017,consecutive patients with PPLs referred for EBUS-GS at a single cancer center were enrolled.The diagnostic yield as well as safety profiles was retrospectively analyzed,and our preliminary experience was shared.Results:A total of 109 patients with 109 lesions were included,99(90.8%)lesions were visible on EBUS imaging.According to the procedure time needed to locate the lesion on EBUS,24.8%(27/109)were deemed technically difficult procedures;however,no significant relationships were identified between candidate parameters and technically difficult procedures.The overall diagnosis yield was 74.3%(81/109),and the diagnostic yield of malignancy was 83.7%(77/92).Lesions larger than 20 mm[odds ratio(OR),2.758;95%confidence interval(95%CI),1.077-7.062;P=0.034]and probe of within type(OR,3.174;95%CI,1.151-8.757,P=0.026)were independent factors leading to a better diagnostic yield in multivariate analysis.About 30 practice procedures were needed to achieve a stable diagnostic yield,and the proportion of technically difficult procedures decreased and stabilized after 70 practice procedures.Regarding complications,one patient(0.9%)had intraoperative hemorrhage(100 mL)which was managed under endoscopy.Conclusions:VBN without fluoroscopy guidance is still useful and safe for PPLs diagnosis,especially for malignant diseases when performed by pulmonologist without previous experience of EBUS-GS.VBN may simplify the process of lesion positioning and further multi-center randomized studies are warranted.
文摘Purpose:To investigate the correlations of pulmonary high-resolution computed tomography(HRCT)findings and their distribution with the peripheral blood immunological parameters of swine-origin influenza A(H1N1)infection.Materials and methods:173 patients with H1N1 influenza infection underwent HRCT.CD4^(+)and CD8^(+)lymphocyte counts and C-reactive protein(CRP)levels in the peripheral blood were measured on the day of admission.According to the predominant HRCT findings,we created three groups:Group A=normal attenuation,Group B=ground-glass opacity(GGO),Group C=consolidation with or without GGO.We classified the extent of lung lesions into five groups as follows:Group 1=CT score of 0;Group 2=CT score of 0.01-0.25;Group 3=CT score of 0.26-0.50;Group 4=CT score of 0.51-0.75;Group 5=CT score of 0.75-1.00.Results:The CD4^(+)and CD8^(+)lymphocyte counts decreased with the degree of the attenuation and the extent of the lesions on HRCT(P<0.001),whereas the CRP levels increased with the degree of the attenuation and the extent of the lesions(P<0.001).Conclusions:The HRCT findings correlated with the CD4^(+)and CD8^(+)lymphocyte counts and the CRP level in the peripheral blood of patients in the initial stage of influenza infections.
文摘BACKGROUND Colorectal cancer(CRC)ranks high among the most common types of malignant tumors.The primary cause of cancer-related mortality is metastasis,with lung metastases accounting for 32.9%of all cases of metastatic CRC(MCRC).However,cases of MCRC in the lungs,which present concurrently with primary peripheral lung adenocarcinoma,are exceptionally rare.CASE SUMMARY This report describes the case of a 52-year-old female patient who,following a colonoscopy,was diagnosed with moderately differentiated adenocarcinoma based on rectal mucosal biopsy findings.A preoperative chest computed tomography scan revealed a ground-glass nodule in the right lung and a small nodule(approximately 0.6 cm in diameter)in the extramural basal segment of the left lower lobe,which suggested multiple lung metastases from rectal cancer.Subsequent treatment and follow-up led to a diagnosis of rectal cancer with left lung metastasis and peripheral adenocarcinoma of the lower lobe of the right lung.CONCLUSION This case report describes the therapeutic journey of a patient with lung metastasis from rectal cancer in addition to primary peripheral adenocarcinoma,thus underscoring the critical roles of multidisciplinary collaboration,personalized treatment strategies,and comprehensive patient rehabilitation guidance.
基金This work was supported by the Clinical Research Plan of SHDC(No.SHDC2020CR3081B)the Science and Technology Commission of Shanghai Municipality(No.20S31905200)+1 种基金the SJTU Trans-med Awards Research(No.20210101)the Joint Clinical Research Center of Institute of Medical Robotics-Chest Hospital,Shanghai Jiao Tong University(No.IMR-XKH202102).
文摘More peripheral pulmonary lesions(PPLs)are detected by low-dose helical computed tomography(CT)either in-cidentally or via dedicated lung cancer screening programs.Thus,using methods for safe and accurate diagnosis of these lesions has become increasingly important.Transthoracic needle aspiration(TTNA)and transbronchial lung biopsy(TBLB)are routinely performed during the diagnostic workup for PPLs.However,TTNA often car-ries the risk of pneumothorax,uncontrollable airway hemorrhage,and does not allow mediastinal staging in one procedure.In contrast,traditional TBLB often has a poorer diagnostic yield despite fewer complications.With the ongoing development of technology applied to bronchoscopy,guided bronchoscopy has become widely used and the diagnostic yield of TBLB has improved.Additionally,guided bronchoscopy continues to demonstrate a better safety profile than TTNA.In recent years,robotic-assisted bronchoscopy(RAB)has been introduced and imple-mented in the diagnosis of PPLs.At present,RAB has two platforms that are commercially available:Monarch TM and Ion TM;several other platforms are under development.Both systems differ in characteristics,advantages,and limitations and offer features not seen in previous guided bronchoscopy.Several studies,including cadaveric model studies and clinical trials,have been conducted to examine the feasibility and performance of RAB using these two systems;large multicenter studies are underway.In this review,published experimental results,focus-ing on diagnostic yield and complications of RAB,are analyzed and the potential clinical application of RAB is discussed,which will enable the operators to have a clear overview of RAB.
